Harassment, Discrimination, & Sexual Misconduct Online Report Form

Harassment, Discrimination, & Sexual Misconduct Online Report Form

This online form may be completed by any member of the Bethel College community who has experienced or otherwise become aware of an incident that may constitute harassment, discrimination, sexual misconduct, retaliation, or any other violation of the Equal Opportunity, Harassment, & Non-Discrimination Policy and Procedures. Sexual misconduct incudes sexual assault, dating violence, domestic violence, stalking, and sexual harassment.

Filing a report with Bethel College does not constitute filing a police report.

Reporting ensures that individuals have access to all of the available support services and options afforded to them by both law and policy. This also helps Bethel College identify and address any trends or systemic problems. Reporting harassment, discrimination, or sexual misconduct helps keep our campus community safe.

 

Reporting Party Information

A reporting party does not need to be the person who experienced the alleged harassment, discrimination, or sexual misconduct. 

Phone Number
Preferred Method of Contact*
Bethel College Affiliation*

Complainant Information

Complainant means an individual who is alleged to be the victim of conduct that could constitute harassment, discrimination or sexual misconduct.

Name*
Phone Number
Bethel College ID
Bethel College Affiliation*

Respondent Information

Respondent means an individual reported to be the perpetrator of conduct that could constitute harassment, discrimination, or sexual misconduct.

Name
Email
Phone Number
Bethel College ID
Bethel College Affiliation
Note: If there is more than one offender please list additional information here.

Incident Information

Approximate Date of Incident*
Incident Location*
Type of Incident*
Protected Class(es) Basis for Report (select all that apply for alleged incidents of harassment or discrimination)
(including disabled veteran, recently separate veteran, active duty wartime or campaign badge veteran, and Armed Forces Service Medal veteran)

Incident Description

Please provide a description of the incident*
Upload Additional Documents
Allowed file types: pdf, doc, docx, png, jpg, jpeg
Please choose one of the following options*
Did the Complainant request supportive measures, such as a no-contact order, changes to campus living, academic, or workplace arrangements?*
Did the Complaint report the incident to local law enforcement?*
Did the Complaint want assistance in reporting the incident to local law enforcement?*
Is the Complainant interested in pursuing a formal complaint with Bethel College against the Respondent?*

Acknowledgement

I understand that in signing and submitting this report that:

  • It will be sent directly to the Bethel College Title IX Coordinator and that the Title IX Coordinator may seek additional information from me related to the incident(s) detailed within this report.
  • Bethel College will seek to contact the Complainant as a result of this report in order to ensure the Complainant’s access to all of the available support services and options afforded to them by both law and policy, including the right to file a formal complaint against the Respondent if so desired.
  • Bethel College’s ability to remedy and respond to this report may be limited if the Complainant does not want Bethel College to proceed with a formal complaint (investigation and/or grievance process). The goal is to provide the Complainant with as much control over the process as possible, while balancing Bethel College’s obligation to protect its community.
  • The information contained within the report is accurate based on the knowledge I have and is being provided in good faith.
  • Any individual identified in this report cannot be retaliated against for participating in or refusing to participate in the Bethel College response and resolution processes.
  • Filing a report with Bethel College does not constitute filing a report with local law enforcement.

 

Please type your name to serve as your digital signature*